Pelvic inflammatory disease. Decision making in the pharmacy and therapeutics committee

In today's environment of cost containment, the pharmacy and therapeutics committee plays an increasingly important role in determining the availability of antibiotics for the treatment of specific diseases. However, if the drug is not optimal for treatment and sequelae of a disease process develop, no true savings are gained. The goal of treating pelvic inflammatory disease should not be just reduction of morbidity but preservation of fertility and reduction of surgery after therapy. Multiple factors must be considered when choosing antibiotic therapy for pelvic inflammatory disease, including the spectrum of pathogenic organisms involved, the efficacy of the antibiotic chosen, the safety profile of the antibiotic, the pattern of resistance to the antibiotic in both the hospital and the community, the cost of administering the antibiotic and management of its side effects. This paper reviews the concepts used at the Chicago Lying-in Hospital, University of Chicago, in choosing the primary antibiotic, ceftizoxime, for the treatment of pelvic inflammatory disease. This antibiotic offers a broad spectrum of antimicrobial activity with little resistance, few side effects, evidence of penetration into the infected tissues and prolonged dosing intervals, which allow substantial cost savings as well as efficacious treatment of acute pelvic inflammatory disease.